Clin Med
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Multicenter Study Comparative Study
British HIV Association national audit on the management of patients co-infected with tuberculosis and HIV.
This audit aims to compare UK management of tuberculosis (TB)/HIV co-infection with recommended practice and to describe local care arrangements. Services providing HIV care were invited to complete a survey of care arrangements and to review case notes of HIV positive patients aged over 16 who started therapy for active TB between October 2007 and April 2008. Corresponding TB services, if separate, were invited to complete a similar survey. ⋯ Culture confirmation of pulmonary TB met the CMO's 65% target. A high number of patients were diagnosed with HIV during investigation of TB. Contrary to current guidelines, many services do not routinely test TB patients for HIV.
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Although telephone consulting is increasingly used by clinicians seeking to balance rising caseloads, heightened patient expectation and the desire to ensure continued improvements in the quality, convenience and accessibility of the care they provide, its use to provide care to renal transplant recipients has not previously been described. Climate change is a major global public health threat. ⋯ This article reports the use of telephone consultation clinics to provide follow-up to renal transplant recipients over a three-year period. The benefits of this service to patients, providers and the environment are outlined, the existing literature regarding the provision of virtual care to patients with kidney disease is reviewed, and the possibilities of more widespread adoption are discussed.